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The Journal of Thoracic and... Dec 2020
Topics: Aortic Aneurysm; Aortic Rupture; Humans; Mitral Valve
PubMed: 31619330
DOI: 10.1016/j.jtcvs.2019.09.013 -
European Journal of Vascular and... Nov 2023
Topics: Humans; Renal Veins; Aortic Aneurysm; Aorta; Aortic Aneurysm, Abdominal
PubMed: 37562762
DOI: 10.1016/j.ejvs.2023.08.004 -
Clinical Cardiology Nov 2020The association between psoriasis and the risk of aortic aneurysm is still unclear. (Meta-Analysis)
Meta-Analysis
BACKGROUND
The association between psoriasis and the risk of aortic aneurysm is still unclear.
HYPOTHESIS
Patients with psoriasis have a higher risk of aortic aneurysm than healthy individuals.
METHODS
PubMed, Embase, and Scopus from inception to 20 July 2019 were searched. We included cohort studies if they reported estimate effects on the risk of aortic aneurysm in patient with psoriasis. We used Newcastle-Ottawa Scale to evaluate methodology quality of eligible studies. Random-effect meta-analyses were used to estimate the overall risk. Subgroup analyses were conducted for analysis of influencing factors.
RESULTS
After a view of 2207 citations, we included three large cohort studies enrolling 5 706 525 participants in this systematic review. Psoriasis patients have an increased risk of development of aortic aneurysm (hazard ratio [HR]: 1.30, 95%confidence intervals [CI], 1.10-1.55, I = 53.1%). The risk is not statistically different between patients with severe psoriasis (HR, 1.51, 95%CI, 1.04-2.19, I = 40.2%) and patients with mild psoriasis (HR, 1.24, 95%CI, 1.08-1.42, I = 24.1%). The risk was not statistically increased in female patients (HR, 1.55, 95%CI, 0.65-3.72), patients ≥50 years old (HR, 4.05, 95%CI, 0.69-23.75, I = 97.3%), and patients with diabetes (HR, 0.97, 95%CI, 0.83-1.14).
CONCLUSIONS
Current evidence from observational studies suggests that psoriasis increases the risk of aortic aneurysm, and screening of aortic aneurysm might be considered among psoriasis patients.
Topics: Aortic Aneurysm; Endovascular Procedures; Global Health; Humans; Incidence; Psoriasis; Risk Assessment; Risk Factors
PubMed: 32757333
DOI: 10.1002/clc.23438 -
Circulation Journal : Official Journal... Nov 2021
Topics: Adipose Tissue; Aortic Aneurysm; Aortic Aneurysm, Abdominal; Humans
PubMed: 34148930
DOI: 10.1253/circj.CJ-21-0388 -
European Journal of Vascular and... Jan 2018Cardiovascular events are common in people with aortic aneurysms. Arterial calcification is a recognised predictor of cardiovascular outcomes in coronary artery disease.... (Observational Study)
Observational Study
INTRODUCTION
Cardiovascular events are common in people with aortic aneurysms. Arterial calcification is a recognised predictor of cardiovascular outcomes in coronary artery disease. Whether calcification within abdominal and thoracic aneurysm walls is correlated with poor cardiovascular outcomes is not known.
PATIENTS AND METHODS
Calcium scores were derived from computed tomography (CT) scans of consecutive patients with either infrarenal (AAA) or descending thoracic aneurysms (TAA) using the modified Agatston score. The primary outcome was subsequent all cause mortality during follow-up. Secondary outcomes were cardiovascular mortality and morbidity.
RESULTS
A total of 319 patients (123 TAA and 196 AAA; median age 77 [71-84] years, 72% male) were included with a median follow-up of 30 months. The primary outcome occurred in 120 (37.6%) patients. In the abdominal aortic aneurysm group, the calcium score was significantly related to both all cause mortality and cardiac mortality (odds ratios (OR) of 2.246 (95% CI 1.591-9.476; p < 0.001) and 1.321 (1.076-2.762; p = 0.003)) respectively. In the thoracic aneurysm group, calcium score was significantly related to all cause mortality (OR 6.444; 95% CI 2.574-6.137; p < 0.001), cardiac mortality (OR 3.456; 95% CI 1.765-4.654; p = 0.042) and cardiac morbidity (OR 2.128; 95% CI 1.973-4.342; p = 0.002).
CONCLUSIONS
Aortic aneurysm calcification, in either the thoracic or the abdominal territory, is significantly associated with both higher overall and cardiovascular mortality. Calcium scoring, rapidly derived from routine CT scans, may help identify high risk patients for treatment to reduce risk.
Topics: Aged; Aged, 80 and over; Aortic Aneurysm, Abdominal; Aortic Aneurysm, Thoracic; Computed Tomography Angiography; Female; Humans; Male; Odds Ratio; Retrospective Studies; Risk Assessment; Tomography, X-Ray Computed; Vascular Calcification
PubMed: 29225032
DOI: 10.1016/j.ejvs.2017.11.007 -
The Medical Journal of Malaysia Feb 2019Aortic disease includes conditions such as chronic aortic aneurysms, acute aortic syndromes and congenital aortic abnormalities, amongst others. This paper reviews all... (Review)
Review
INTRODUCTION
Aortic disease includes conditions such as chronic aortic aneurysms, acute aortic syndromes and congenital aortic abnormalities, amongst others. This paper reviews all research on aortic disease performed in Malaysia and published between 2000-2016.
METHODS
A literature search was conducted in PubMed, Scopus, MyJurnal and the UKM Journal Repository. The search process was based on a previously published methodology. The medical subject headings (MeSH) search terms used were "aortic", "aorta" and "Malaysia".
RESULTS
Two-hundred-thirteen papers were identified, of which 60 papers were selected and reviewed on the basis of their relevance. The epidemiology, pathophysiology, clinical presentations, case reports, investigations, treatment and outcomes of aortic disease in Malaysia were reviewed and summarised. The clinical relevance of the studies performed are discussed.
CONCLUSION
The review provided an insight into the pathophysiology, prevalence and epidemiology of aortic diseases in Malaysia, how the condition is managed, and the outcomes of treatment. Limitations of the research performed in Malaysia to date were identified and recommendations for further research and improvement in clinical practice were recommended.
Topics: Aortic Dissection; Aortic Aneurysm; Aortic Diseases; Biomedical Research; Humans; Malaysia
PubMed: 30846666
DOI: No ID Found -
European Journal of Vascular and... Jan 2020This meta-analysis sought to identify the mortality and ambulatory state 30 days and one year post-operatively in octogenarians treated for ruptured abdominal aortic... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
This meta-analysis sought to identify the mortality and ambulatory state 30 days and one year post-operatively in octogenarians treated for ruptured abdominal aortic aneurysm (rAAA) by endovascular aneurysm repair (EVAR) or open repair (OR). rAAA is a life threatening emergency occurring increasingly in octogenarians. Surgical treatment, open or endovascular, offers the only chance of survival albeit with significant mortality and morbidity rates and a high burden to society. In order to make an informed decision on management, contemporary treatment outcomes should be known. The aim of this study was to perform a systematic review and meta-analysis on rAAA repair in octogenarians.
METHODS
The Pubmed, Embase and Cochrane databases were searched for articles published between 2013 and October 2018 on octogenarians treated for a rAAA. Meta-analysis was performed using the random effects model to calculate the 30 day and one year mortality.
RESULTS
The search resulted in a total of 1569 articles, of which eight retrospective studies could be included, reporting on 7526 patients. All studies reported 30 day mortality in octogenarians, and the one year mortality was addressed in four studies. Ambulatory state was not reported. Meta-analysis showed a 30 day mortality of 43% (95% confidence interval (CI) 33-53) and a one year mortality of 47% (95% CI 32-62). Patients after EVAR had a significant lower mortality at 30 days (risk ratio (RR) 0.50, 95% CI 0.38-0.67) and at one year (RR 0.65, 95% CI 0.44-0.96).
CONCLUSION
The 30 day and one year mortality rates for rAAA repair in octogenarians are similar to the outcome at all ages, with a significant survival advantage of EVAR over OR. Patients should therefore not be denied treatment of a rAAA based on age alone.
Topics: Age Factors; Aged, 80 and over; Aortic Aneurysm, Abdominal; Aortic Rupture; Clinical Decision-Making; Emergency Treatment; Endovascular Procedures; Hospital Mortality; Humans; Survival Analysis; Time Factors; Treatment Outcome
PubMed: 31810836
DOI: 10.1016/j.ejvs.2019.07.014 -
The Journal of Thoracic and... Oct 2020
Topics: Aorta; Aortic Aneurysm, Abdominal; Aortic Aneurysm, Thoracic; Blood Vessel Prosthesis Implantation; Humans
PubMed: 31610959
DOI: 10.1016/j.jtcvs.2019.08.072 -
European Journal of Vascular and... Jun 2017
Topics: Aortic Aneurysm, Abdominal; Aortic Rupture; Humans; Vascular Surgical Procedures; Workload
PubMed: 28456596
DOI: 10.1016/j.ejvs.2017.03.021 -
British Journal of Hospital Medicine... Apr 2024Acute aortic dissection is often misdiagnosed as a result of its atypical presentations. It affects 4000 patients a year in the UK of all ages, not just older patients,... (Review)
Review
Acute aortic dissection is often misdiagnosed as a result of its atypical presentations. It affects 4000 patients a year in the UK of all ages, not just older patients, with increasing numbers of cases expected in the future because of the ageing population. Dissection of the aortic wall leads to sudden, severe pain, and commonly end-organ symptoms which must be recognised. Acute aortic dissection can be challenging to diagnose in the emergency department because of the multitude of possible presentations and the need for selective testing with Computed Tomography Angiography (CTA). Clinicians often miss acute aortic dissection because it is not considered in the differential diagnosis, and the challenge lies in identifying acute aortic dissection in a sea of complaints of chest, back and abdominal pain. There are several ways to improve diagnosis, including awareness campaigns, better education about patients in which to consider acute aortic dissection, and improved detection strategies including which patients should receive CTA. Clinical decision tools and biomarkers could help, but further research is required and is a research focus in emergency medicine. Once diagnosed, blood pressure control, analgesia and urgent surgery or transfer to enable this to occur with minimal delay is required.
Topics: Humans; Aortic Dissection; Emergency Service, Hospital; Computed Tomography Angiography; Acute Disease; Aortic Aneurysm; Diagnosis, Differential
PubMed: 38708978
DOI: 10.12968/hmed.2023.0366